Laboratory Use Only Ministry of Health and Long-Term Care ... 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the requisitioning clinician's name and address in the designated fields. Ensure that all contact numbers are accurate for urgent results.
3. Fill in the patient's details, including their last name, first and middle names as per the OHIP card, health number, date of birth, and telephone contact number.
4. Select the appropriate options for service date and check the relevant boxes for tests required under biochemistry, hematology, immunology, microbiology, etc.
5. Provide any additional clinical information that may assist in processing the requisition. This could include diagnosis or specific test requests.
6. Finally, ensure to sign and date the form at the bottom before submitting it through our platform for processing.

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